食管中下段癌切除、胃食管弓上吻合两种术式对胃—食管返流及肺活量影响的研究

目的：探讨食管中下段癌切除术中，胸胃经食管床再经主动脉弓后与上段食管吻合术式，与传统上经弓前至弓上吻合术式比较，何种途径更能减少胃－食管返流及肺活量的损害。方法：对入院适合作上述术式的病例按前后两个时段分成两组，第1组按传统做法，第2组采取经弓后至弓上吻合，两组分别各完成15例，共30例。然后进行术后同位素测定返流比值及比较肺活量术前、后的改变，再进行统计学上的分析，观察它们是否存在区别及何种术式在上述两方面的功能更优。结果：分别经两种术式处理后的病例，同位素返流比值及肺活量的变化均显示有显性差异。且弓后组在减少返流及对肺活量损害等方面的功能更优。结论：经弓后途径较弓前途径更能减少术后胃－食管返流和肺活量的减损。

The effects of two different procedures for esophage-gastroanastomosis upper arcuate on gastro-esophageal reflux and breathing capacity after medial and lower esophageal carcinoma resection

Objective:To explore which is the better procedure at reducing of gastro-esophageal reflux and breathing capacy injury between posterio-arcuate-passage and anterior-arcuate-passage esophago-gastroanastomosis in medial and lower esophageal carcinoma resection.Method:According to the operation indications and patients admission time,30 cases were divided into 2 groups of 15 each.Group 1 patients underwent traditional anterior-arcuate-passage anastomosis,and group 2 patients underwent anterior-arcuate-passage anastomosis(through the bed of esophagus),the post-operative isotopic reflux proportionality and peri-operative breathing capacity were analyzed statistically.Result:There were significant differences in changes of reflux proportionality and breathing capacity between the 2 groups after the 2 different procedures.The posterio-arcuate-passage esophage-gastroanastomosis reduced gastro-esophageal reflux and breathing capacity injury more prepotently.Conclusion:Posterio-arcuate-passage esophago-gastroanastomosis is better than anterior-arcuate-passage at reducing of gastro-esophageal reflux and breathing capacity injury.